1487933248 NPI number — COUNTY OF VOLUSIA

Table of content: (NPI 1487933248)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487933248 NPI number — COUNTY OF VOLUSIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF VOLUSIA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DIVISION OF EMERGENCY MEDICAL SERVICES, DIVISION OF FIRE SERVICES
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487933248
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
112 CARSWELL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLY HILL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32117-5010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
386-252-4900
Provider Business Mailing Address Fax Number:
386-252-4986

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
125 W NEW YORK AVE
Provider Second Line Business Practice Location Address:
SUITE 182
Provider Business Practice Location Address City Name:
DELAND
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32720-5415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-740-5201
Provider Business Practice Location Address Fax Number:
386-626-6618
Provider Enumeration Date:
08/11/2011

Additional Information

Authorized Official

Authorized Official Last Name:
RECKTENWALD
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
Authorized Official Title or Position:
COUNTY MANAGER
Authorized Official Telephone Number:
386-736-5920

Provider Taxonomy Codes

  • Taxonomy code: 3416A0800X , with the licence number:  ALS6407 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: ALS6407 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com